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Authorization to Appoint Intermediary Submit to: Attention:Joanne WilliamsDate:Fax Number:012 679 4419Email:commissions@profmed.co.members Details (all these fields are compulsory) Full names: Surname: Prof

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How to fill out online profmed intermediary form

01

Go to the Profmed website and locate the online intermediary form.

02

Fill in your personal details such as name, contact information, and relevant qualifications.

03

Provide information about your brokerage or intermediary firm including name, address, and contact details.

04

Upload any necessary supporting documents such as proof of registration or certification.

05

Review the form for accuracy and completeness before submitting it online.

Who needs online profmed intermediary form?

01

Insurance brokers or intermediary firms who wish to work with Profmed and access their products and services.

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What is online profmed intermediary form?

The online profmed intermediary form is a form used to report information about medical professionals who act as intermediaries for procurement of medical supplies.

Who is required to file online profmed intermediary form?

Medical professionals who act as intermediaries for procurement of medical supplies are required to file the online profmed intermediary form.

How to fill out online profmed intermediary form?

To fill out the online profmed intermediary form, medical professionals must provide information about the medical supplies procured, the parties involved, and any relevant financial transactions.

What is the purpose of online profmed intermediary form?

The purpose of the online profmed intermediary form is to increase transparency in the procurement of medical supplies and prevent fraud and abuse.

What information must be reported on online profmed intermediary form?

Medical professionals must report information about the medical supplies procured, the parties involved, and any financial transactions related to the procurement.

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